Provider Demographics
NPI:1417221029
Name:ROMANOFF, TATYANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TATYANA
Middle Name:
Last Name:ROMANOFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 GLEN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2741
Mailing Address - Country:US
Mailing Address - Phone:650-703-3490
Mailing Address - Fax:
Practice Address - Street 1:4800 HEDGCOXE RD STE 150
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2404
Practice Address - Country:US
Practice Address - Phone:214-227-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist